Quality Assurance Activities
A.F. Al-Assaf in Managed Care Quality, 2020
Among health care professionals, there are many definitions and uses of the word “standard.” The term standard sometimes is used to describe protocols, standard operating procedures, specifications, and practice guidelines. Guidelines are statements by experts that describe recommended or suggested procedures. (Eddy and Couch, 1991) Guidelines serve as a flexible technical reference that describe what the health care provider should or should not do for a given clinical condition, e.g., guidelines for vascular injury in frostbite cases. (Imparato and Rites, 1989) A protocol is a more precise and detailed plan for a process, such as the management of a clinical condition. A protocol implies a more stringent requirement than a guideline, such as WHO protocols for diarrhea case management. A standard operating procedure (SOP) is a statement of the expected way in which an organization’s staff carries out certain activities, such as standard operating procedures for billing patients. Standard operating procedures usually are more stringent than guidelines. A specification is a detailed description of the characteristics or measurements for a product, service, or outcome.
Private Medical Insurance
Christopher Locke in Private Medical Practice, 2018
The health insurers are now considering a wide range of options aimed at reducing costs generally, including the cost of professional fees. Chief among these is the idea of establishing clinical protocols. There have been moves in the NHS to try and minimize unnecessary expenditure by developing such protocols, against which the activities of individual consultants or departments can be judged. These involve detailed research, out of which representative panels of learned clinicians deduce a consensus of opinion governing a particular procedure. This might concern, for instance, the length of inpatient stay following such an operation. From the available data, an ‘average’ would be established and a protocol drawn up covering situations during which an earlier or later date of discharge might be justified. The larger health insurers have been actively courting the Royal Colleges and individual experts in an attempt to establish such protocols for the more expensive areas of consultant activity. Publication of these protocols provides the insurers with the means with which to query ‘excessive’ charges by clinicians or hospitals. By doing so they may restrict further the clinical freedoms of individual consultants, though it could be argued that these are already being restricted to the same extent in the NHS.
Collegiate and High School Sports
Mark R. Lovell, Ruben J. Echemendia, Jeffrey T. Barth, Michael W. Collins in Traumatic Brain Injury in Sports, 2020
Subsequent to the work conducted by Barth and colleagues, the next systematic utility of neuropsychological testing for sports concussion was implemented with the Pittsburgh Steelers in the early 1990s. This work is discussed elsewhere in this text. This was followed by the development of the NHL League-wide neuropsychological testing program. Such work has resulted in a solid methodological foundation for more widespread utilization of neuropsychological testing protocols for both professional and amateur athletes (Lovell, 2002). In fact, promulgation and utilization of neuropsychological testing protocols for sports concussion management have essentially become the standard for safe management. Evidence of this fact is that neuropsychological testing was recently deemed the “cornerstone” of concussion management by a multi-disciplinary panel of international concussion experts (Aubry et al., 2002). Over the past several years and subsequent to the work by Barth and colleagues, many advances have been made from both a test development and methodological standpoint. We will now review two clinical/research programs that highlight the nature of these advances and illustrate a practical and user-friendly methodology for protocol implementation.
Practice measures for controlling and preventing hospital associated Clostridium difficile infections
Published in Hospital Practice, 2019
Daryl Ramai, Aaquib Noorani, Andrew Ofosu, Emmanuel Ofori, Madhavi Reddy, James Gasperino
Antibiotic use remains one of the strongest risk factors for the acquisition of CDI. The antibiotics most commonly implicated in CDI include clindamycin, cephalosporins, and fluoroquinolones [35]. However, multiple antibiotic use and prolonged duration of antibiotic treatment also pose significant risk. Antimicrobial stewardship programs (ASP) in hospitals aim to optimize antibiotic prescribing methods to improve individual patient care and retard the spread of antimicrobial resistance. This is accomplished through programs or interventions such as the creation of educational materials for clinicians and healthcare personnel and control audits observing hand washing. While there are no standard protocols for ASPs, there are various guidelines offered to prepare and implement a location focused program [49]. The United States Centers for Disease Control and Prevention (CDC) proposed hospital personnel to serve as the foundation of a proper ASP (Table 2) [50]. An effective ASP would tailor interventions following the local antibiotic utilization patterns, available resources and expertise [51]. A facility-specific clinical protocol based on local epidemiology and infection patterns should be developed with the experts available to the hospitals, and protocols would also require implementation and audits to ensure effective practice. Optimal use of antibacterial takes into account the likely hood of drug resistance, severity of illness, source of infection, route of medication administration, and shortest effective duration of therapy [52,53].
Tests and classification methods in adaptive designs with applications
Published in Journal of Applied Statistics, 2023
Diana Q. Chen, Si-Qi Mao, Xu-Feng Niu
Clinical trials play an important role in medical research, in which participants (usually human volunteers) receive specific interventions based on the protocol designed by the researchers. The interventions in a clinical trial could be different medical products, such as new drugs, new devices, or new procedures that are compared with a placebo. Adaptive designs in clinical trials were proposed in the 1970s when Efron [11] discussed how to balance a sequential experiment. Wei [34] introduced a class of designs for sequential clinical trials, the biased-coin design, for the purpose of reducing experimental bias and increasing the precision of inference about treatment effects. The main idea of an adaptive design in clinical trials is that the investigator may modify trial and/or statistical procedures based on the review of data from different stages during the experimental process, which may identify clinical benefits of the treatments more efficiently and increase the success probability of the clinical development without undermining the validity and integrity of the trial.
Detection of human papillomavirus infection in laryngeal and hypopharyngeal carcinoma using droplet digital PCR and its correlation with prognosis
Published in Postgraduate Medicine, 2021
Lixiao Chen, Pin Dong, Ziwei Yu
Patients with SCCLHP who were treated at our hospital from June 2016 to July 2019 were eligible for this study. The patients were followed-up via telephone, inpatient, and outpatient consultations until December 2019. Written informed consent was obtained from all patients. Scientific and ethical approval of the study protocol was obtained from the respective scientific committees for clinical research at our hospital (No. 2020ky095). This clinical study was registered (clinical trial registration no. ChiCTR2000033032). All the patients in this study received internationally standardized treatment according to the National Comprehensive Cancer Network guidelines. A formalin-fixed paraffin-embedded tumor sample was obtained after consent for analysis. Strictly adhering to the operation manual, each tumor tissue sample was cut aseptically with a separate blade and packed in a clean, sterile tube without any contamination.
Related Knowledge Centers
- Clinical Trial
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